CPCs Unplugged, Part 2: Free Ultrasound, But At What Cost?
moiv printable version print page     Bookmark and Share
Tue Aug 22, 2006 at 02:50:52 AM EST
"A Picture is Worth a Thousand Words"

Photobucket - Video and Image HostingThat's why the Pregnancy Resource Centers of Greater Portland ensure that "Free ultrasound exams are available to all abortion-vulnerable clients in all six locations."  Despite token disclaimers of performing ultrasound only for "medically eligible" clients, countless other unregulated crisis pregnancy centers across the country follow the same non-medical protocols.  

A human price could be paid for the thousands of medically unjustifiable "free" ultrasound exams performed in CPCs -- "pro-life ministries" sponsored by the religious right and financed by public grants -- that fly below the radar of FDA regulation.

Troubling studies have repeatedly demonstrated [pdf link] that prolonged exposure to ultrasound can produce damaging effects upon the tissues of the developing human fetus.

A 1993 study published in the Lancet cautioned that it was "plausible" that multiple ultrasound scans were responsible for retarded fetal growth. In a 1990 article, Dr. Kenneth J.W. Taylor -- Professor of Diagnostic Radiology and Chief of the Ultrasound Section at Yale University School of Medicine -- said, "I would not let anybody get near my infant's head with a transducer unless I knew what the output was."  

Good advice, since a 2001 Mayo Foundation study found that prenatal ultrasounds expose a fetus to sound levels registering at 100 decibels, as loud as "a subway train coming into a station." And University of Calgary researchers concluded that "[a]n association between prenatal ultrasonography exposure and delayed speech was found."

Now new research strongly suggests that overexposure to ultrasound affects fetal brain development, contributing to disorders ranging from "mental retardation and childhood epilepsy to developmental dyslexia, autism spectrum disorders and schizophrenia." The researchers' conclusion is that "ultrasound ... exposure should be kept low and unregulated uses should be avoided."

Dr. Joshua Copel, president-elect of the American Institute of Ultrasound Medicine, states it plainly: "Anytime we're doing an ultrasound, we have to think of risk vs. benefit. What clinical question are we trying to answer?"

But CPCs that perform ultrasound have a question of their own: "What do we have to do to prevent a woman from having an abortion?"  

Just as they did last week in Crisis Pregnancy Centers Unplugged, CPC operators answer that question in their own words.

[Unless otherwise attributed, all quotations are from emailed communications publicly posted and available online at PCC Talk.org.]

How does a cash-strapped CPC "ministry" manage to afford an expensive ultrasound machine in the first place?  Over 200 of them have simply called up Dr. James Dobson, whose Focus on the Family writes them a check for 80% of the cost.

I am the ED [executive director] of a PRC that just completed "going medical". We participated in the Focus on the Family Ultrasound Project and received our machine in late September. ... To date, every expense has been met.  We projected that it would cost us $20,000 (based upon figures given to us by Focus) to get converted.  
:::
I would highly recommend offering this service.  It is not as scary as it seems at first.  If you participate in the Focus on the Family project, they are there to help every step of the way.  ...  I suggest that you contact Focus as your first step.

A typical center in Anchorage offers ultrasound scans for reasons that please Dr. Dobson, but would fail to pass muster with Dr. Copel.  This CPC promotes its free ultrasound scans online by appealing to women's fears that something might be wrong - something such as ectopic pregnancy [Is my pregnancy located where it should be (in the uterus--not in the tube)?] or miscarriage [Is my pregnancy progressing? (The miscarriage rate in early pregnancy can be 1 in 5.)].

Photobucket - Video and Image Hosting

The ostensible reason that CPCs such as the Crisis Pregnancy Center of Metro Richmond offer ultrasound is to give a woman the information she needs to make a choice, even though only one choice is on the table.

The procedure takes about 30-45 minutes and offers valuable knowledge during pregnancy. At the CPC our goal is provide you with accurate and up-to-date information about pregnancy and abortion so that you can make a fully informed decision ...

That's right -- 30-45 minutes of ultrasound exposure for a simple scan that, in the hands of a qualified technician, takes less than ten. Of course, in CPC World, a trained ultrasound professional is someone who takes an online course from the National Institute of Family Life Advocates (NIFLA), which also provides advice on potential legal liability for CPCs and includes a link to the American Institute of Ultrasound in Medicine, vaguely implying an AIUM endorsement of its practices.

But this is the official statement of the AIUM regarding fetal ultrasound performed for what it calls "psychosocial" or "bonding and reassurance purposes."

The AIUM recommends that appropriately trained and credentialed medical professionals (either licensed physicians, registered sonographers, or sonography registry candidates) who have received specialized training in fetal imaging perform all fetal ultrasound scans. These individuals have been trained to recognize medically important conditions, such as congenital anomalies, artifacts associated with ultrasound scanning that may mimic pathology, and techniques to avoid ultrasound exposure beyond what is considered safe for the fetus. Any other use of "limited medical ultrasound" may constitute practice of medicine without a license.

Now that we're clear on what does and does not constitute a medical indication for fetal ultrasound, and who is and who is not qualified to perform it, let's sit back and listen to CPC operators dish about their own medical and ethical standards.  

And isn't it reassuring to learn that some of them make at least an outward show of compliance?

How do you medically justify more than one US [ultrasound] if you know it is a viable IUP [intrauterine pregnancy]??

Please email me PRIVATELY!!!  DO NOT RESPOND ONLIST!  This is to keep your answers secure.

There are ways to get around some of those pesky state medical regulations -- you know, the same rules that CPC defenders complain aren't tough enough on the medically regulated, state licensed and stringently inspected clinics that have physicians on site and provide accurate, factual information about pregnancy, contraception and abortion care.  Yes, indeed, even for "medical" CPCs, there are ways.

In NJ we are not required to be licensed if doing U/S less than 8 hours per week.  So, we had an RN trained at Shari Richards week long U/S class and put together a Medial [sic] Policy and Procedure manual (a combo of CareNets and NIFLA's).
:::
Our Corvus 260 U/S machine was a $23,000 model, new 1 year ago.  We received a NJ grant for it.

No license, and no state regulation or oversight, even though this CPC, like so many others, is doing ultrasound exams with the state's money.  Still, it's too bad that "abortion vulnerable" doesn't have its own diagnosis code in the ICD-10 manual. Because at A Woman's Concern near Penn State, the most overriding medical indication for a sonogram seems to be catching pregnant students before they get away.

Our ultrasound tech does scans as early as 5 1/2 weeks because he can see a sac at that time and our college women are eager to know anything. We have a chance to gain trust and ... [w]e never have any trouble getting them to come back in a week when we hopefully will see further development ... . We have found too many times if we ask them to wait for that initial visit they will never come.

That's two exposures of a very early, very fragile embryo to potentially damaging ultrasound in one week, simply because, if a young woman doesn't come into the CPC right now, she might not come in at all.  

A CPC in Concord, California, has the same problem, and applies the same non-medical ethic in resolving it.

Whether to put off an ultrasound for a week or two is a gray area. If the client seems strongly abortion minded, I would try the ultrasound right then, if they will allow me to do a vaginal one. If they do not seem strongly abortion minded and they are less than 6.5 weeks I might try to schedule them to come back in a week.

We found at 5-6 weeks we can't visualize the baby well enough to make an impact. It's not that the baby is a "blob", it just that the baby is very tiny and still way down in the pelvis and ... difficult to capture adequately on our older ultrasound and with our limited training.

But even outdated machines, limited training and utter disregard for medical guidelines don't tell the whole story on lack of "impact." When the subject is CPCs, there's always more.

[W]e here in Roanoke, VA, have been talking about how effective our ultrasound machine has been in helping clients to change their minds.  I don't know about you, but when I first started hearing about the push for CPCs to go medical, the numbers pertaining to client impact seemed astronomical!  All of the reports I heard indicated that if a woman saw her baby via ultrasound, the chances that she would change her mind and carry the baby skyrocketed!  

In Roanoke we have not seen this happen and we're trying to figure out why.

 

According to a colleague in Texas, the Roanoke center's numbers are down because they aren't doing post-sonogram "counseling" with shock-graphic videos so gory that they cause controversy even among the most strident anti-choicers.  

We in Beaumont, Texas have been using ultrasound for 3 years and our success rate is running 95%.  The key is agressive [sic] counseling immediately after the sonogram.  We have "Harder Truth" ( the video) if needed ...  Again, the key is to have another counseling session with them after the ultrasound in the form of an "exit intension" [sic].

Medical necessity for ultrasound is what the CPC's medical director says it is, and Alternate Avenues in Upland, California has a simple protocol to weed out the moochers.

We only provide free ultrasounds to clients we consider "at-risk" [for abortion] because the standing order from our physician states that is what makes it medically necessary.

We never perform ultrasounds for clients who are pregnant and just want to see their baby. We simply tell them that under doctor's orders, we don't perform ultrasounds for any other reason except when medically necessary. So far they seem to accept this explanation.

That's about what you'd expect from a physician who tells women that emergency contraception is the same thing as medical abortion, and that "women who abort face a 50% increase in breast cancer" and up to a 50% higher risk of suicide.  

The business manager of yet another center worries about squandering its resources . . .

Can you all share with me the time frame you use to schedule the ultrasound of an abortion vulnerable/minded client.  The # of weeks along.  Some discussion I've heard is that if the US is done too early then the client only sees a "blob" and will have the abortion.

. . . and finds understanding from a CPC nurse in Clarksville, Tennessee.

We started out using 6 weeks as our guidelines but were soon noticing that several of our clients were not as far along as they thought. ... If you perform them too early, you run the risk of exactly what you mentioned.  The client thinks, "Well, there's nothing there...just like I thought".  Because of this we changed our guidelines to a minimum of 7 weeks.

However, it's really a fine line to tread.  You don't want to wait too long either because she may never come back.

One nurse isn't concerned about possible harm to a fetus, but does worry about legal liability if her CPC upgrades to the new "3-D" or "4-D" ultrasound technology merely for "entertainment" purposes. And besides, a more detailed image could reveal fetal anomalies that motivated a woman to have an abortion.

I do not feel that the 3-4 d. technology is necessary for what we are here to do.
 :::    
Because we are mostly staffed by volunteer nurses "trained in limited ultrasound."  I wonder if the "entertainment" risk is worth it or necessary.  

I think that this issue much thanks to Tom Cruise will be coming out more this year!!. ( auim site on there [sic] thoughts about this!!!   Yes I want my girl to bond with her baby and choose life!!!  but at what legal risk??  I wonder if my center is being put More at risk by handing out 3 d images.  

They frequently are to [sic] early to be clear anyway, but can I fully note a heart anomaly, spine or cephalic problem, or other things more easily seen on a 3 d image?  I have not had the training to do so. But don't want a client to see these things often easily recognized in 3 d and decide to abort because of them (like cleff [sic] lip or pallette [sic])!

But "entertainment" sonograms aren't going away anytime soon, because they're a favorite tool for CPCs that need to beef up their budgets.  No fund-raising banquet seems complete these days without a live ultrasound demonstration to impress potential donors, as is revealed in this email exchange.  

Oh my gosh you wouldnt [sic] be open to doing an ultra sound at our banquet, would you? That would be so cool. We will have our peer mentoring group there and it would be cool for them to see it also. ... Please let me know if you would be willing and what you charge.

I've never performed an ultrasound at a banquet before but that doesn't mean I would not.  
:::
Another option for you is Connie Ambrecht of Sonography now. ... She also performs ultrasounds for banquets.

The third option is to do what we did last November at our banquet.  We wanted to showcase our new machine and what we were moving toward with our new ultrasound ministry.  ...  We have two pro-life OB/GYN's that work with us and these two men actually performed the ultrasounds with me assisting.  NOTE:  VOLUNTEER PHYSICIAN, NO FEES INVOLVED!!  
:::
Approximately one week before the banquet, each performed a "practice" ultrasound on our model to familiarlize [sic] himself with her specific case.  The night of the banquet, we had our model and physician arrive about 30 minutes before the seating started and did one more quick "run-though" just to make sure everything was okay.  It worked out so beautifully ...   Our model was 12 weeks pregnant.  We joked with the audience that our model's baby was the most photographed baby in Clarksville!

Dr. Copel of the AIUM takes a stern view of unregulated sonography: "We don't know what equipment they're using, what the acoustic output is, and what the training of the personnel is." And with the federal government's embrace of the religious right's CPC ministries, the FDA has stopped enforcing its own rules on ultrasound output and exposure.

We can only hope that everything turns out all right for the "most photographed baby in Clarksville," and for all the others.

Photobucket - Video and Image Hosting

But if the "culture of life" really cared anything about fetuses except making sure that women carry them, they'd care about whether they could be inflicting irreparable damage on babies before they're even born.

[Title image from Georgetown University Hospital]




Display:
Huang et al. (1994) examined the biological effects of diagnostic ultrasound on the embryo with gestational age of 6-8 weeks prior to induced abortion. They found various degrees of change in the ultrastructure of the chorionic villi in those exposed to ultrasound for between 10 and 30 minutes, with the most significant changes in those exposed for 30 minutes.

Feng-Zeping et al. (1996) irradiated fetuses at 20-28 week gestation with diagnostic ultrasound prior to abortion. Those irradiated for 30 minutes showed microscopic damage to the fetal testes.

CPC scans lasting 30-45 minutes are completely unnecessary, of course, aimed only at emotionally manipulating the woman, but they could be doing real harm to her embryo or fetus, too.


by moiv on Tue Aug 22, 2006 at 03:43:45 AM EST

It is amazing how oblivious zealots can be as they pursue their aims.

by Frederick Clarkson on Tue Aug 22, 2006 at 12:31:35 PM EST
Parent


I have actually been to a clinic like that and the sonogram was 10-15 minutes.  It did take 45 minutes but that was because they talked to me before and afterward.  I liked it there.  I ended up miscarrying and didn't have to pay for an abortion.  It was a huge relief.  Maybe I had a better center than the ones you were talking about.  I don't know.  I just know I was thankful in the end to have gone there.

by star28 on Fri Sep 01, 2006 at 05:19:32 PM EST


WWW Talk To Action


Censorship Challenge: Texas Pastor Seeks Restrictions On `Dangerous' Library Books
Back in the 1990s, some Religious Right activists in Virginia got the bright idea to begin attacking America's public libraries. The idea was to......
By Rob Boston (0 comments)
Suspended St. Louis County Officer Dan Page Made Rounds on Rightwing Radio Shows
St. Louis Police Officer Dan Page drew national attention when he shoved CNN's Don Lemon during a broadcast of the protests in Ferguson, and......
By Rachel Tabachnick (1 comment)
Cop Who Shoved CNN Host Don Lemon Lassoed in Another Conspiracy Rodeo
Rachel Tabachnick broke an important story this evening showing that the rant by Officer Dan Page that got him suspended from the St.Louis County......
By Frederick Clarkson (0 comments)
Exile Excitement: Some Fundamentalists Seek Escape From Decadent Society
OK, now we've done it. Those of us who advocate things like separation of church and state, secular government, LGBT rights and self-determination when......
By Rob Boston (2 comments)
Controversy Over White Nationalist GOP Candidate Still White Hot
The 2004 Constitution Party candidate for president Michael Peroutka's current race for County Council in Maryland -- as a Republican -- it is still......
By Frederick Clarkson (0 comments)
Race, Republicans and the Religious Right
The Republicans have a race problem, and by this I don't just mean that racial minorities don't much vote for them, particularly in the......
By Frederick Clarkson (1 comment)
Rev. William Barber on Religious/Political Inclusiveness
A few weeks ago, I posted about the extraordinary oration of Rev. William Barber at Netroots Nation. (A transcript of the speech is now......
By Frederick Clarkson (0 comments)
Short Takes
Salon.com  Columnist Thomas Frank considers how snark can cut more than one way. What does it mean when being "on the left" is defined......
By Frederick Clarkson (1 comment)
David Brat as a "Libertarian Catholic" is an Oxymoron
David Brat, the Tea Party Young Turk who recently shocked the GOP establishment with his primary win over Majority Leader Eric Cantor, is reportedly,......
By Frank Cocozzelli (2 comments)
Kountze Cheerleaders Take on the Courts
The entire town of Kountze, Texas is in a frenzy with business banners, suv window paintings and legal action supporting their local cheerleaders. The......
By wilkyjr (2 comments)
A Talk to Action Anthology on Neo-Confederacy, Nullification and Secession (Updated)
A number of posts over the past year have addressed the growing Neo-Confederate movement, the advocacy of nullification of federal laws, and even the......
By Frederick Clarkson (5 comments)
Good Incentives Gone Awry: Kentucky Officials Are Adamant About Propping Up The 'Ark Park'
I've lived in the Washington, D.C., suburbs since 1986, so when it comes to museums, I am spoiled. Just a short subway ride away......
By Rob Boston (2 comments)
White Hot Controversy for a White Nationalist GOP Candidate
The controversy over Michael Peroutka's theocratic, white nationalist candidacy for county council, in Anne Arundel County, Maryland -- has gotten white hot after he......
By Frederick Clarkson (2 comments)
Not Just Whistling 'Dixie': Peroutka Stands Up for Southern Secession - UPDATED x2!
Cross-posted from The Huffington Post. Michael Peroutka, the Republican candidate for Anne Arundel County Council, stood up for secession and the white nationalist League......
By jhutson (1 comment)
Short Takes
Pando Daily:  Journalist Mark Ames has published a must-read story about how Reason,the flagship magazine of libertarianism, published a special issue in 1976 promoting......
By Frederick Clarkson (0 comments)

Republican infighting in Mississippi
After a bruising GOP runoff election for U.S. Senator, current MS Senator Thad Cochran has retained his position and will face Travis Childers (Democrat) in the next senate election. The MS GOP is fractured......
COinMS (1 comment)
America's Most Convenient Bank® refuses to serve Christians
Representatives of a well known faith-based charitable organization were refused a New Jersey bank’s notarization service by an atheist employee. After inquiring about the nature of the non-profit organization and the documents requiring......
Jody Lane (3 comments)
John Benefiel takes credit for GOP takeover of Oklahoma
Many of you know that Oklahoma has turned an unrecognizable shade of red in recent years.  Yesterday, one of the leading members of the New Apostolic Reformation all but declared that he was responsible......
Christian Dem in NC (2 comments)
John Benefiel thinks America is under curse because Egyptians dedicated North America to Baal
You may remember that Rick Perry put together his "Response" prayer rallies with the help of a slew of NAR figures.  One of them was John Benefiel, an Oklahoma City-based "apostle."  He heads up......
Christian Dem in NC (2 comments)
Mississippi Religious Freedom Restoration Act.
Yes, that's right. We have totally lost our religious freedom in Mississippi and it must be restored by our legislators. ......
COinMS (1 comment)
Bill Gothard accused of harassing women and failing to report child abuse
Surprised no one's mentioned this, but one of the longest-standing leaders of the religious right is in a world of trouble.  Bill Gothard has been active in the fundie movement for over half......
Christian Dem in NC (1 comment)
Eugene Delgaudio may lose his day job as Virginia county supervisor
Surprised no one's noticed this, but one of the nation's most virulent homophobes is in a fight to keep his day job.  Eugene Delgaudio is best known as the head of Public Advocate......
Christian Dem in NC (0 comments)
Starkville Becomes First City in Mississippi to Pass Resolution Recognizing LGBT Residents
This caught me by surprise. I guess times are a changin in Dixieland. ------------------------------------- Cross posted from the HRC blog. Starkville Becomes First City in Mississippi to Pass Resolution Recognizing LGBT Residents January 21,......
COinMS (0 comments)
Robert Knight: Running against evolution could potentially be a winner for the GOP
In one of the starkest instances yet of how far gone the religious right is, one of its leading activists thinks that he's found another potential wedge issue that could drive more people into......
Christian Dem in NC (2 comments)
First Catholic official convicted in child sex abuse scandal has conviction overturned
Last year, Monsignor William Lynn, the Archdiocese of Philadelphia's secretary for clergy, was convicted of reassigning a priest whom he knew had molested a young boy to a parish that had a school attached......
Christian Dem in NC (0 comments)
Quotes From Sarah Palin 'War on Christmas" Book v. Quotes From 1920s Anti-Jewish Propaganda
The point of this comparison is not to cast Sarah Palin as a Nazi. Rather, my intent is to underline uncomfortable similarities between contemporary "war on Christmas" talking points propagated by elements of the......
Bruce Wilson (0 comments)
Francis sets up commission on how to deal with pedophile priests
Late yesterday Pope Francis announced--apparently after some prodding--that he will set up a panel to advise him on how to deal with child abuse by priests. The announcement was a forthright acknowledgment by the......
Christian Dem in NC (0 comments)
John Hagee: Jews will make deal with Antichrist before End Times
When John Hagee opens his mouth, you expect to hear lunacy.  An appearance earlier this month on TBN was no different.  On Friday, People for the American Way stumbled on a special prophecy-focused edition......
Christian Dem in NC (0 comments)
Doug Phillips Resigns From Vision Forum over "Inappropriate Relationship"
Doug Phillips resigned as president of Vision Forum earlier this week, citing an "inappropriate relationship."   Phillips posted an announcement on the Vision Forum website, stating, There has been serious sin in my life......
Rachel Tabachnick (2 comments)
A Wiccan Witch In Salem
Since it's only two weeks from Halloween, I made my usual foray into Christian Right Country to find out what their plans are for this Halloween. I don't know where to be sad or......
irishwitch (0 comments)

More Diaries...




All trademarks and copyrights on this page are owned by their respective companies. Comments, posts, stories, and all other content are owned by the authors. Everything else 2005 Talk to Action, LLC.